Do No Harm?

The doctor giveth, and the doctor taketh — or that’s how proponents of physician-assisted suicide would have it. A person’s so-called “right to die” through physician-assisted suicide is absent from the US Constitution, yet the subject calls into question a person’s individual freedoms, and the extent of those freedoms. Should our doctors be allowed to let us die, if we wanted it to, if it ever came to that? The term “physician-assisted death” encompasses three practices: halting or foregoing artificial life support for someone with a terminal illness; giving someone the means to end his or her life, per a specific request; and deliberately causing a terminally-ill person’s death. One side of the debate sees physician-assisted suicide as an abuse of the role of a physician; what kind of doctor actively tries to end their patient’s life? Many are outraged by such a paradox. Unsurprisingly, the American Medical Association’s Code of Ethics asserts that physician-assisted suicide is “fundamentally incompatible with the physician’s role as healer.” This view, however, reflects a misunderstanding of what healing someone actually entails. Restoring someone to perfect health is ideal, but where this is impossible, the patient and the doctor must consider: is it worth it? The point of healing is to alleviate pain, and doing so — whether through a standard surgery or through administering drugs that will cause certain death — is still within the realm of a doctor’s role in reducing suffering. Choosing to forgo life support actually involves the doctor very little. Ultimately, the decision to voluntarily end a person’s life falls to the patient’s family acting on the patient’s behalf or the patient’s clear wishes. The question of the morality of physician-assisted death moves to the foreground when the doctor becomes essential to the process by providing the means for the patient to commit suicide. This situation is usually the source of people’s moral outrage. That being said, a patient who decides that living is no longer a viable option because of unavoidable suffering must take precautions to prevent making any rash decisions. If the patient is mentally capable, they must speak with a professional about their reasons for such a decision, as well as notify their immediate family. Three of the four states that have legalized physician-assisted suicide provide for other legal requirements, such as a minimum age of 18, six months or less until expected death, and a minimum of three requests to a physician (two oral and one written). The reasons behind the decision are absolutely necessary to consider, especially since physician-assisted suicide becomes increasingly barbaric as the possibility of familial or hospital pressure due to money concerns enters the conversation. For this reason, a trained medical professional must examine the patient to determine that the prospect of carrying out the act is due to the patient’s desire to “die with dignity” rather than stress from relatives with less-than-noble interests. In their role as healers, doctors and their employers, the hospitals, are also tasked with creating a comfortable environment for people living out their final days — whether through hospice care or pain medication. Patients that resolutely desire to die, however, may attempt suicide through other, more sudden and more painful means. The end result is the same; the process is, however, much more tragic and much less manageable from a legal standpoint. Going through a delineated process once a patient has decided to die allows the family and the patient a way to come to terms with the death, as well as a clear amount of time in which to do so. While states should make every effort to legalize euthanasia, they must follow the legal provisions set in place by Oregon, Vermont, and Washington. Law-makers and doctors must take every precaution to give the patient the power to decide, since individual liberty should include the right to die a dignified death. The law can only go so far in trying to keep people from feeling unnecessary social pressures to commit suicide, however, so precautions are essential in discouraging people from making any rash decisions. Ultimately, it must be within the patient’s control to push that button, to swallow that pill, to sign that document — or to back out and choose life.